Clinical Depression

What is Clinical Depression?

When we refer to depression in the following pages, we are
talking about "clinical depression." Clinical depression
is a serious medical illness that negatively affects how you feel,
the way you think and how you act. Individuals with clinical depression
are unable to function as they used to. Often they have lost interest
in activities that were once enjoyable to them, and feel sad and
hopeless for extended periods of time. Clinical depression is
not the same as feeling sad or depressed for a few days and then
feeling better. It can affect your body, mood, thoughts, and behavior.
It can change your eating habits, how you feel and think, your
ability to work and study, and how you interact with people. People
who suffer from clinical depression often report that they "don't
feel like themselves anymore."

Clinical depression is not a sign of personal weakness, or a
condition that can be willed away. Clinically depressed people
cannot "pull themselves together" and get better. In
fact, clinical depression often interferes with a person's ability
or wish to get help. Clinical depression is a serious illness
that lasts for weeks, months and sometimes years. It may even
influence someone to contemplate or attempt suicide.

People of all ages, genders, ethnicities, cultures, and religions
can suffer from clinical depression. Each year it affects over
17 million American men and women (source: American Psychiatric
Association). While clinical depression is common, it is frequently
unrecognized and untreated.

There are different types and levels of clinical depression.
Mental health counselors and psychiatrists are trained to diagnose
and treat clinical depression. With the right treatment, most
people who seek help get better within several months. Many people
begin to feel better in just a few weeks.

Common Symptoms of Clinical Depression

There are different forms of clinical depression with different
combinations of the following symptoms:

Headaches, stomachaches, digestive problems or other
physical symptoms that are not explained by other physical
conditions or do not respond to treatment

Behavioral/Attitude:

Loss of interest or pleasure in activities that were
once enjoyed, such as going out with friends, hobbies,
sports, sex, etc.

Difficulty concentrating, remembering, or making decisions

Neglecting responsibilities or personal appearance

Emotional:

Persistent sad or "empty" mood, lasting two
or more weeks

Crying "for no reason"

Feeling hopeless, helpless, guilty or worthless

Feeling irritable, agitated or anxious

Thoughts of death or suicide

Types of Depression:

Clinical depression can come in different forms. It may start suddenly
or build up over a period of weeks, months, or years. The following
are descriptions of the three most prevalent forms, though for an individual,
the number, severity and duration of the symptoms may vary.

Major Depression: a combination of symptoms (described above)
that interfere with one's ability to work, sleep, eat and enjoy once
pleasurable activities. These episodes can occur once, twice or several
times in a lifetime.

Dysthymia: a less intense type of depression that involves
long-term, chronic symptoms that are less severe, but keep one from
functioning at full ability and from feeling good.

Bipolar Disorder (also known as manic-depressive illness):
periods of depression alternate with periods of elation and increased
activity, known as mania. See More about Bipolar
Disorder.

How Is Clinical Depression Different From Normal
Stress and Sadness?

Feeling sad and depressed is often a normal reaction to a stressful
life situation. For example, it is normal to feel down after a major
disappointment, or to have trouble sleeping or eating after a difficult
relationship break-up. Usually, within a few days, perhaps after talking
to a friend, we start to feel like ourselves again.

Clinical depression is very different. It involves a noticeable change
in functioning that persists for two weeks or longer. Imagine that for
the last three months you've slept more than 10 hours a day and still
feel tired, you have stomach problems, you're unable to cope with life,
and you wonder if dying would solve all your problems. Or, imagine not
being able to sleep more than four hours a night, not wanting to spend
time with family or friends, and constantly feeling irritable. And when
friends try to reach out to you, you get even more upset and bothered.
You lose perspective, and you don't realize that what you're experiencing
is abnormal. You want to just "wait it out," and you don't
get help because you think it's weak to ask for help or you don't want
to burden your friends.

These are some of the experiences that people can have when they suffer
from clinical depression. Unlike normal stress and sadness, the symptoms
of clinical depression persist and do not go away no matter how much
the individual wants.

What Causes Depression?

You may feel you know exactly why you're depressed. Other times, however,
the reasons for depression are not as clear. The causes of depression
are quite complex. Very often it is a combination of genetic, psychological,
and environmental factors. Regardless of the cause, depression is almost
always treatable. You do not need to determine the cause of your depression
to get help.

Biological factors: You may have heard about chemical imbalances
in the brain that occur in depression, suggesting that depression is
a medical illness. Depression does seem to have a biological component.
Research suggests that depression may be linked to changes in the functioning
of brain chemicals called neurotransmitters. Current research focuses
on the serotonin, norepinephrine and dopamine systems. The usefulness
of antidepressant medications suggests that brain chemistry is involved
in depression. However, it is also possible that biological changes
happen as a result of being depressed.

Some kinds of depression seem to run in families, suggesting a biological
vulnerability. This seems to be the case with bipolar depression and,
to a lesser extent, severe major depression. However, having a biological
vulnerability does not mean you are destined to become depressed. Not
everyone in a family develops depression, suggesting that other factors
are involved. In addition, depression can occur in individuals who have
no family history of depression.

Stress: Psychological and environmental stressors can contribute
to a depressive episode. Common stressors among college students include:

academic demands

transitions-re-entry to school, being new to Berkeley

balancing school, work, family, social life

financial responsibilities or worries

family concerns

social isolation

difficulties in relationships with friends and romantic partners

being on one's own in a new environment

exposure to new ideas, new people, and temptations

awareness of sexual identity and orientation

preparing for life after graduation, career decision-making

A major loss, chronic illness, relationship problems, work stress,
family crisis, or unwelcome life changes can often trigger a depressive
episode, even in individuals without a family history or genetic predisposition.

Psychological Tendencies: Psychological make-up can play a role
in vulnerability to depression. People with low self-esteem, who consistently
view themselves and the world with pessimism, or are readily overwhelmed
by stress, may be especially prone to depression.

Alcohol or Other Drug Use: A lot of depressed people, especially
young adults and men, have problems with alcohol or other drugs. Sometimes
the depression comes first and people try alcohol or other drugs as
a way to escape it. Other times, the alcohol/drug use comes first, and
the drug itself, or withdrawal from it, or the problems caused by substance
use, may lead to depression. Sometimes you can't tell which came first.
The important point is that when you have both of these problems, the
sooner you get treatment, the better. If you are taking medication for
depression and abusing alcohol or other drugs, your medication will
not work effectively. Medication should never be discontinued without
talking to your doctor.

Men and Depression

Depression can strike anyone regardless of age, background, socioeconomic
status or gender. However, in any given year, 12% of women (nearly 12
million women) in the United States are diagnosed with depression compared
to 7% of men (over 6 million men). Important questions remain about
the causes underlying this gender difference and whether depression
truly is less common among men, or whether men are less likely than
women to recognize, acknowledge and seek treatment for depression.

Research at the National Institute of Mental Health (NIMH) on depression
awareness has shown that many men are unaware that physical symptoms
such as headaches, digestive disorders, and chronic pain can be associated
with depression. Depression in men can present itself differently than
in women. Men are more likely to acknowledge fatigue, irritability,
loss of interest in hobbies, sleep disturbances, and discouragement,
rather than feelings of worthlessness or guilt. Men's depression is
more often masked by alcohol or other drugs, or by the socially acceptable
habit of working excessively long hours.

Even if a man realizes he is depressed, he may be less likely to seek
help. Men express concern about seeing a mental health professional,
thinking that people would find out and it might have a negative impact
on their job security, promotion potential, or health insurance benefits.
Men may fear that being labeled with a diagnosis of mental illness would
cost them the respect of their family and friends. On campus, male students
may be more concerned about their standing in their academic department,
or being labeled as weak, if they seek help. Encouragement and support
from concerned family members and friends can make a difference. Significant
others play an important role in helping men recognize their symptoms
and getting treatment.

More About Bipolar Disorder

Bipolar disorder is characterized by cycling mood changes: severe highs
(mania) and severe lows (depression). Sometimes the mood switches are
dramatic and rapid, but most often are gradual. When in the depressed
cycle, an individual can have any of the symptoms of a depressive disorder.
When in the manic cycle, an individual is overly "up" or irritable.
Someone in a manic state may appear excessively talkative and energetic,
with little need for rest or sleep. This can affect thinking, judgment,
and social behavior in ways that cause serious problems and embarrassment.
For example, an individual in a manic phase may feel elated, full of
grand schemes, or engage in reckless spending sprees or increased sexual
activity. Individuals who are in a manic state may feel in possession
of special powers or abilities that others can't understand. Bipolar
Disorder is treatable.